Provider Demographics
NPI:1184130130
Name:RICHARDS, MELISSA AMBER (LMSW)
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:AMBER
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1008 S LIVINGSTON ST
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:MI
Mailing Address - Zip Code:49461-1719
Mailing Address - Country:US
Mailing Address - Phone:231-736-6032
Mailing Address - Fax:
Practice Address - Street 1:401 S ELIZABETH ST
Practice Address - Street 2:
Practice Address - City:WHITEHALL
Practice Address - State:MI
Practice Address - Zip Code:49461-1349
Practice Address - Country:US
Practice Address - Phone:231-724-3808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-28
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801101498101YM0800X
104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty